Erectile dysfunction Male impotence
Erectile dysfunction is a problem that affects a large proportion of men, estimated at between 20 and 50%.
There are numerous risk factors for erectile dysfunction, such as diabetes mellitus, hypertension, smoking, sedentary lifestyle, dyslipidemia, obesity, lower urinary tract symptoms, antidepressant medication, some antihypertensive medication, others.
Erectile dysfunction can be caused by vascular (atherosclerosis), neurogenic (diabetes, stroke, multiple sclerosis, Parkinson's disease, alcohol abuse), psychogenic (depression, anxiety), hormonal, traumatic or medical or surgical treatments.
Your doctor may, for example, ask you if the onset of symptoms was sudden or gradual, whether there was any trauma or change in your personal / professional situation, if you have morning erections, can reach orgasm, ejaculate normally or have dimished libido.
There are some validated questionnaires, such as the International Index of Erectile Function (IIEF), which can help diagnose the problem.
Hormonal profiles and complementary exams such as Penile doppler ultrasound , cavernosometry or penile arteriography are examples of procedures that may be useful in the diagnosis of erectile dysfunction.
The treatment involves diagnosing and treating the source of the problem and is defined on a case-by-case basis.
There are some curable causes of erectile dysfunction, especially those of psychogenic, post-traumatic and hormonal arteriogenesis.
Some general measures, such as lifestyle changes and re-education, are important adjustments that may be acquired in sexual pshycotherapy sessions.
These measures may not be sufficient, leading the treatment to medications such as phosphodiesterase-5 inhibitors and alprostadil (urethral or injectable), or alternative therapies such as low intensity shock wave treatment and vacuum devices.
In some cases, when all other options fail, surgical placement of a semi-rigid or inflatable penile prosthesis may be used.
In most cases, diverse therapies are used simultaneously, since their effects are potentiated among themselves.